Tumors and other abnormal tissues can be treated in any one of a variety of manners. In one method, a tumor can be removed from the afflicted patient by retrieving the tumor from the surrounding tissue. For example, breast cancer, if not in an advanced stage that would otherwise require a radical mastectomy (i.e., complete removal of the breast), can be treated using a breast conserving surgical procedure, such as lumpectomy, tumorectomy, segmental mastectomy, or local excision, which involves removal of the suspect tissue and a margin of healthy tissue surrounding the suspect tissue through an open or keyhole incision. In some cases, breast tumors may be removed during a biopsy procedure, e.g., using a tissue retrieval device, such as that described in U.S. Pat. No. 6,471,659.
In any case, the excised interstitial space, which is left behind after removal of the tissue, is typically treated under the theory that a thin finite layer of cells contained within the tissue margin surrounding the interstitial space may be diseased, yet undetectable under the current range of technology, and that even a single malignant cell left in the margins of an excised interstitial space can multiply into a new tumor. Treatment of the margins of the interstitial space is key in reducing the recurrence rate of the disease.
Conventional techniques involving the post-operative treatment of the interstitial space include radiation, chemotherapy, and brachytherapy. Although general ionic radiation treatment utilizes equipment that is commonly available, it must be administered as multiple treatments over a period of weeks, and sometimes months. As a result, general radiation treatment is logistically challenging, time consuming, and costly. In addition, healthy tissue outside of the targeted zone is typically damaged during the radiation process. Focused external beam radiation therapy can be administered to minimize adverse affects to the surrounding healthy tissue. However, external beam radiation therapy utilizes less common equipment, which is typically costly, difficult to find, and/or filled to capacity.
Chemotherapy involves treating the interstitial space with toxic chemotherapeutic agents to destroy any remaining malignant cells. Due to the extreme toxicity of chemotherapeutic agents and variability in the size of the margin, however, chemotherapeutic treatment of an excised interstitial space will lead to the destruction of many healthy, and sometimes critical, cells. Also, due to the large size of the interstitial space relative to areas requiring treatment, it is difficult to obtain predictive infusion of a drug. Furthermore, filling an excised interstitial space results in the use of an excess quantity of the chemotherapeutic agent, which increases the cost of treatment. Increasing the dose of chemotherapeutic agent also increases the amount of the agent absorbed into a patient's system, making it difficult to achieve a therapeutic concentration of a drug locally at a target site within the excised interstitial space without producing unwanted systemic side effects.
Standard brachytherapy techniques require simultaneous placement of numerous catheters in the interstitial space and surrounding tissue. Placement of these catheters can be costly, cumbersome, and time-consuming. New brachytherapy methods, such as the Mammosite® Radiation Therapy System (RTS), use a balloon to deliver a conformal dose of radiation to the tissue over a treatment span of five days. To uniformly radiate the tissue margin around the interstitial space, however, it must be ensured that the balloon contacts the entirety of the wall surrounding the interstitial space. Also, even though the new brachytherapy methods focus therapy in the targeted regions, the use of radiation still poses a danger and is relatively expensive.
It has also been proposed to ablate the wall surrounding the interstitial space using a radio frequency (RF) ablation probe, which would require relatively inexpensive and conventional equipment. The use of RF electrical energy to ablate tissue also has little side effects. However, because RF electrical energy will not ablate tissue in air, the use of RF electrodes in interstitial spaces is ineffective.
For this reason, it would be desirable to provide improved methods and systems for treating interstitial spaces after abnormal tissue, such as a tumor, is excised from a patient.